The prevalence of mental health conditions in healthcare workers during and after a pandemic: Systematic review and meta‐analysis

Abstract

Aims: This review aims to explore the prevalence and incidence rates of mental health conditions in healthcare workers during and after a pandemic outbreak and which factors influence rates.Background: Pandemics place considerable burden on care services, impacting on workers' health and their ability to deliver services. We systematically reviewed the prevalence and incidence of mental health conditions in care workers during pandemics.Design: Systematic review and meta-analysis. Data sources: Searches of MEDLINE, Embase, Cochrane Library and PsychINFO for cohort, cross-sectional and case-control studies were undertaken on the 31 March 2020 (from inception to 31 March 2020).Review methods: Only prevalence or incidence rates for mental health conditions from validated tools were included. Study selection, data extraction and quality assessment were carried out by two reviewers. Meta-analyses and subgroup analyses were produced for pandemic period (pre-and post), age, country income, country, clinical setting for major depression disorder (MDD), anxiety disorder and post-traumatic stress disorder (PTSD). Results:No studies of incidence were found. Prevalence estimates showed that the most common mental health condition was PTSD (21.7%) followed by anxiety disorder (16.1%), MDD (13.4%) and acute stress disorder (7.4%) (low risk of bias).For symptoms of these conditions there was substantial variation in the prevalence estimates for depression (95% confidence interval [CI]:31.8%; 60.5%), anxiety (95% CI:34.2%; 57.7%) and PTSD symptoms (95% CI,21.4%; 65.4%) (moderate risk of bias).Age, level of exposure and type of care professional were identified as important moderating factors. Conclusion:Mental disorders affect healthcare workers during and after infectious disease pandemics, with higher proportions experiencing symptoms.

Mental Health Support for Hospital Staff during the COVID-19 Pandemic: Characteristics of the Services and Feedback from the Providers

“…A large-scale meta-analytic atlas including 173 studies (n = 502,261 individuals) and investigating mental health problems during the COVID pandemic reported that anxiety, depression, and post-traumatic symptoms were more prevalent in LMICs, although this was not specifically a study of HCWs [ 35 ]. A recent systematic review and meta-analysis of the prevalence of mental health conditions specifically in HCWs during and after a pandemic highlighted the paucity of data from LMICs [ 36 ]. Nevertheless, many LMICs, particularly those in Africa, have previous experience of epidemics, such as Ebola virus, or major traumatic events (e.g., Rwandan genocide of 1994), which have promoted resilience and a culture of mental health support.…”

The North Italian Longitudinal Study Assessing the Mental Health Effects of SARS-CoV-2 Pandemic Health Care Workers—Part II: Structural Validity of Scales Assessing Mental Health

“…The absence of scalar invariance of the refined version MBI over the pandemic waves has some consequences. Cross-sectional studies have shown that burnout after the pandemic has a very high prevalence, and longitudinal studies that burnout levels have increased as a result of the pandemic [ 8 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. If the lack of longitudinal scalar invariance that was found in this study is generalized to other countries and populations, it might be hard to disentangle the presence of true differences in the levels of burnout from differences in how HCWs respond to the items of the MBI from the pandemic on.…”

“…The COVID-19 pandemic seems to have exacerbated this issue due to repeated exposure to life-threatening situations, fear of contagion, shift overload and changes in work organization [ 8 , 9 ]. The results of longitudinal studies and the comparison between the estimates of the studies performed before and during the pandemic show a high prevalence and a marked increase of the levels of anxiety, with estimates from studies performed during the pandemic ranging from 22% to 31%, depression (from 17% to 36%), PTSD symptoms (from 13% to 37%) and burnout (from 36% to 52%) [ 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ]. Among the protective factors, studies have shown that resilience and post-traumatic growth helped to buffer the impact of the pandemic, suggesting that these factors should be taken into account in order to describe the mental health of HCWs [ 18 , 19 ].…”

Assessment of Anxiety, Depression, Work-Related Stress, and Burnout in Health Care Workers (HCWs) Affected by COVID-19: Results of a Case–Control Study in Italy

“…There is sufficient evidence that mental health problems have affected healthcare workers’ health during this pandemic [ 6 , 7 , 8 ].…”